Tackling viral outbreaks

Last week, India’s health ministry officially endorsed a 2010 WHO communiqué declaring H1N1 swine flu to be endemic in India. That means, even though this particular strain of the virus may lose its potency and kill far fewer people than during the pandemic years of 2009-2010, it implies that the virus is now present in a substantial section of the Indian population and this greatly increases the chances that it may combine with any of the other viruses endemic in India and form a new, deadly strain. At last count, 132 people have died from an H1NI infection.

Were India serious about flu epidemics and set in place adequate infrastructure to effectively monitor—and publicize—the progress of an epidemic, as well as quarantine a victim of particularly virulent strain, this news of the H1N1 becoming endemic might not have been as worrisome.

Currently, it is only the National Institute of Virology that is explicitly tasked with studying viruses. Given the plethora of dangerous bugs, from Japanese encephalitis to the Crimean-Congo haemorrhagic fever virus that sporadically erupt and proliferate as epidemics and outbreaks in India, scientists at this institution are burdened. They rarely devote as much time as they should to devise strategies to halt the spread of these pathogens.

Then there is the vexatious issue of managing vaccination. While it is of some relief that Indian vaccine makers now have the capabilities to churn out prophylactic vaccines at relatively short notice, there’s no adequate mechanism to ensure that these vaccines aren’t brazenly prescribed and as easily available in pharmacies as several kinds of antibiotics. There are already well-established concerns that the surfeit of antibiotic prescriptions is responsible for the emergence of new kinds of drug-resistant infections and similar problems could emerge with vaccines.

While there is little that can be done to stem the random emergence of mutations, there is much that health authorities in India ought to do to step up surveillance efforts, organize special teams to study and analyse flu outbreaks continuously as part of quotidian research and not just when they threateningly emerge on the horizon.

It is time that government medical research establishments form deeper links with private research organizations and expend greater effort and seriousness to tackle flu epidemics. While malaria and tuberculosis are no doubt far greater concerns for Indian healthcare, that cannot be an alibi for slacking on swine flu.

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